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学科主题: 公共卫生
题名:
A case study of the counterpart technical support policy to improve rural health services in Beijing
作者: Jian, Weiyan1; Chan, Kit Yee1,2; Tang, Shunv1; Reidpath, Daniel D.3
关键词: Rural-urban health service inequality ; Counterpart technical support policy ; Health service reform ; Health services accessibility ; Healthcare disparities ; Rural population ; Urban population ; National health programs ; China
刊名: BMC HEALTH SERVICES RESEARCH
发表日期: 2012-12-29
DOI: 10.1186/1472-6963-12-482
卷: 12
收录类别: SCI ; SSCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Health Care Sciences & Services
研究领域[WOS]: Health Care Sciences & Services
关键词[WOS]: CASE-MIX ; CHINA ; URBAN ; PERFORMANCE
英文摘要:

Background: There is, globally, an often observed inequality in the health services available in urban and rural areas. One strategy to overcome the inequality is to require urban doctors to spend time in rural hospitals. This approach was adopted by the Beijing Municipality (population of 20.19 million) to improve rural health services, but the approach has never been systematically evaluated.

Methods: Drawing upon 1.6 million cases from 24 participating hospitals in Beijing (13 urban and 11 rural hospitals) from before and after the implementation of the policy, changes in the rural-urban hospital performance gap were examined. Hospital performance was assessed using changes in six indices over-time: Diagnosis Related Groups quantity, case-mix index (CMI), cost expenditure index (CEI), time expenditure index (TEI), and mortality rates of low- and high-risk diseases.

Results: Significant reductions in rural-urban gaps were observed in DRGs quantity and mortality rates for both high- and low-risk diseases. These results signify improvements of rural hospitals in terms of medical safety, and capacity to treat emergency cases and more diverse illnesses. No changes in the rural-urban gap in CMI were observed. Post-implementation, cost and time efficiencies worsened for the rural hospitals but improved for urban hospitals, leading to a widening rural-urban gap in hospital efficiency.

Conclusions: The strategy for reducing urban-rural gaps in health services adopted, by the Beijing Municipality shows some promise. Gains were not consistent, however, across all performance indicators, and further improvements will need to be tried and evaluated.

语种: 英语
WOS记录号: WOS:000314637700001
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/56120
Appears in Collections:北京大学公共卫生学院_期刊论文

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作者单位: 1.Peking Univ, Hlth Sci Ctr, Dept Hlth Policy & Management, Sch Publ Hlth, Beijing 100191, Peoples R China
2.Univ Melbourne, Nossal Inst Global Hlth, Carlton, Vic 3010, Australia
3.Sch Med & Hlth Sci, Selangor 46150, DE, Malaysia

Recommended Citation:
Jian, Weiyan,Chan, Kit Yee,Tang, Shunv,et al. A case study of the counterpart technical support policy to improve rural health services in Beijing[J]. BMC HEALTH SERVICES RESEARCH,2012,12.
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